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目的:探讨重度脑卒中恢复期伴进食障碍病人进行肠内营养(EN)支持前后,营养状况指标、耐受性和感染并发症的对比研究。方法:检测45例脑卒中恢复期病人治疗前、治疗后1、3和6个月血清总蛋白(TP)、清蛋白(ALB)、前清蛋白(PA)、血红蛋白(Hb)、转铁蛋白(TF)、糖化血红蛋白(HbA1c)、IgA和IgG等指标,并进行对比,比较治疗前后感染发生率和抗生素使用时间,并观察EN半年内的依从性和耐受性。结果:治疗后1个月,PA和TF优于治疗前(P<0.05);治疗后3个月,ALB、Hb和IgG优于治疗前(P<0.05),PA和TF改善更加明显;治疗后6个月,TP、ALB、PA、Hb和TF较治疗前有增高(P<0.05),其中TF和IgG较治疗后3个月增高更明显(P<0.05)。IgA和HbAlc治疗前后无显著性差异。感染并发症和抗生素使用时间均明显减少。结论:EN支持可明显改善重度脑卒中恢复期病人的营养状况,提高免疫力,减少感染并发症的发生率。
OBJECTIVE: To investigate the nutritional status, tolerability and infection complication before and after enteral nutrition (EN) support in severe stroke recovery patients with eating disorders. Methods: The levels of serum TP, ALB, PA, Hb, transferrin (TF), HbA1c, IgA and IgG, and compared the incidence of infection and antibiotic use time before and after treatment, and observed compliance and tolerability of EN within six months. Results: At 1 month after treatment, PA and TF were superior to those before treatment (P <0.05); ALB, Hb and IgG were superior to those before treatment (P <0.05) at 3 months after treatment, After 6 months, the levels of TP, ALB, PA, Hb and TF were higher than those before treatment (P <0.05). TF and IgG increased more significantly after 3 months of treatment (P <0.05). IgA and HbAlc no significant difference before and after treatment. Infection complications and antibiotic use time were significantly reduced. Conclusion: EN support can significantly improve the nutritional status of patients with severe stroke recovery, improve immunity and reduce the incidence of infection complications.